WESTPORT, CT (Reuters Health) - The near-absence of an HIV-specific cytotoxic
lymphocyte (CTL) response in a patient with extremely rapid disease
progression emphasizes the importance of a robust HIV-specific immune
response in combating the disease, according to a recent report.
Dr. James F. Demarest, from Duke University Medical Center in Durham, North
Carolina, and colleagues analyzed the immunologic and virologic profile of a
35-year-old black male who progressed from initial HIV infection to death in
less than 6 months. The patient was not treated with antiretroviral therapy.
While the patient had an altered humoral response, the most distinctive
immunologic feature was the near-absence of detectable HIV-specific CTL
responses, the researchers note in the September 20th issue of AIDS Research
and Human Retroviruses.
Immune cell analysis revealed a decreased percentage of CD8+ cells expressing
CD45R0 and CD28 and an increased percentage of cells expressing CD45RA and
Limited sequence diversity was noted in primary viral isolates recovered
throughout the disease course, the authors state. While cloned viral
envelopes demonstrated broad coreceptor usage patterns, there was no evidence
that infection occurred through these alternative receptors. The viral
isolates maintained an R5 phenotype throughout the course of infection.
"Much emphasis has been placed on the virus and its coreceptor as
determinants of disease stability/progression," the investigators note. The
current findings suggest that the ability to mount an HIV-specific immune
response during the early stages of infection may be an equally important
determinant of disease progression.
AIDS Res Hum Retroviruses 2001;17:1333-1344.